Elapegademase-lvlr (Revcovi)

Covered for ADA‑SCID (pediatric and adult) when diagnosis is confirmed by bi‑allelic ADA gene mutations or baseline ADA catalytic activity <1%; off‑label uses are not covered. Requires prescription by or consultation with an immunologist/hematologist‑oncologist/ADA‑SCID specialist, 12‑month authorizations, IM weekly dosing with specified Adagen‑to‑Revcovi conversion and titration rules (Adagen‑naïve start 0.4 mg/kg weekly split into 0.2 mg/kg twice weekly for 12–24 weeks; if prior Adagen dose unknown or ≤30 U/kg start 0.2 mg/kg weekly; if >30 U/kg calculate equivalent), and documentation of genetic/enzymatic confirmation, specialist involvement, and prior Adagen dosing or weight records as applicable.

"Use of Revcovi for ADA-SCID when diagnosis is supported by absent or very low (less than 1% of normal) adenosine deaminase catalytic activity at baseline."

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